Psychiatrists are increasingly being contacted by the media to comment on
persons whose violent acts have captured national attention. The tragedy at
Virginia Tech last month left the media clamoring for sound bites from
psychiatrists and other mental health professionals. Sadly, it was mostly
sensational commentary, including speculative opinions about the shooter (for
example, he was "psychotic," "delusional,""
paranoid," "schizophrenic," "autistic"),
which was deemed newsworthy. The reporting of responsible, scientifically
based statements from our colleagues was the exception.
It is alarming and an embarrassment for our profession to have reckless
assertions of this kind disseminated by the media. But they do serve the
purpose of raising important questions about our professional conduct. How
should our profession respond to requests for media interviews?
Psychiatrists are bound by the ethical code of the medical profession,
specifically defined in The Principles of Medical Ethics of the AMA
and in APA's The Principles of Medical Ethics With Annotations Especially
Applicable to Psychiatry (hereafter "Principles").
These Principles are "standards of conduct that define the
essentials of honorable behavior for the physician." Within these
Principles can be found clear direction on the ethical requirements
for communicating with the media. Section 5 and Section 7 speak most directly
to this issue:
Educating the public about psychiatric matters and human behavior is not
only ethical but laudable and encouraged by the Principles. There is
still general misunderstanding about mental illness, and public education not
only addresses this area, but also the associated stigmatization of persons
who are mentally ill. What do the Principles specifically say about
commenting on individuals in the public eye?
This passage is referred to as the "Goldwater Rule." How did
this eponym come about? A presidential column by APA's 126th president,
Herbert Sacks (1997—1998), explains its origin:
"We are reminded of the 1964 Goldwater-Johnson election, when 1,189
American psychiatrists responded to an inquiry for their opinions of the
candidates by a now defunct magazine [Fact magazine]. The bulk of the
political responses, couched in psychiatric terminology, were so unfair and so
outrageous to Goldwater that he sued and won a substantial settlement. APA
issued public statements decrying such analyses and in 1973, when The
Principles of Medical Ethics With Annotations Especially Applicable to
Psychiatry were drafted, Section 7.3 stated [see above]."
Dr. Sacks also noted in his column, "Psychobabble reported by the
media undermines psychiatry as science." His words remain true
When commenting on individuals in the public eye, psychiatrists should be
governed by concerns for the potentially inflammatory and harmful consequences
of their statements. The reputation of the public figures involved, their own
credibility, and the dignity of our profession are at stake. Only after
performing an examination and receiving an appropriate waiver of
confidentiality should psychiatrists comment on persons in the light of public
attention. Recent speculative and uninformed public statements made about the
Virginia Tech shooter's mental state violate our Principles.
Psychiatrists speaking to the media must avoid statements that are demeaning
to the profession and our patients.
In the event an APA member is contacted by the media for an interview, we
encourage him or her to first examine his or her motivation for responding. Is
it to help educate the public about the science of mental illness, human
behavior, and the interface between psychopathology and violence? If so, then
providing responsible, measured information based on scientific
literature—and not speculating about an individual who has neither been
examined nor provided authorization for being discussed—is ethical and
encouraged. On the contrary, if one's motivation is to seek fame or to
increase referrals to one's practice, then just say no, as this is not
ethical. Appropriate responses by psychiatrists will prove beneficial by
educating the public, promoting the reputation of psychiatry, and protecting
those persons subjected to public scrutiny.
The Principles of Medical Ethics With Annotations Especially Applicable
to Psychiatry is posted on APA's Web site at<www.psych.org/psychpract/ethics/ethics.cfm>.▪